The cost of training doctors, both in terms of expenditure on medical education and in terms of the induced demand for NHS expenditure created by having more doctors initiating care and cure, are considerable. However, the forecasting of their number and the planning of their utilisation remain...

Drawing on evidence collected from all providers of community care in 6 districts, this study finds: 1. Total public expenditure on all services for community for community care client groups distributed across providers as follows: DHAs – 52% Local authorities – 34% DHSS benefit payments...

As a contribution to the current debate on the future of the NHS, this paper sets out a framework with which proposals for reform can be analysed. Eight different proposals are classified according to their dominant methods of finance and provision of health care. Criteria are then developed by...

Introduction 1. In recent years considerable efforts have been made to increase the evidence base for decision making within the NHS. Under the NHS R&D Programme a sizeable percentage of NHS resources have been spent on research, one of the largest programmes of research being in the field of...

This paper reports work undertaken for the UK Department of Health to explore approaches to measuring and comparing hospital productivity. The purpose of the cost indices produced in this paper has been to use them to derive productivity scores for English NHS Trusts in order to benchmark them...

In 1992, the Measurement and Valuation of Health (MVH) Group at the Centre for Health Economics conducted a study with Social and Community Planning Research (SCPR) comparing different methods of valuing health states (Dolan et al, 1993). A random sample of 335 members of the general population...

The White Paper Our Health, Our Care, Our Say noted concerns about geographical equity of access to GPs (Department of Health, 2006, page 63), listed the 30 PCTs with the lowest number of GPs per head of need adjusted population, and set out policy initiatives to attract additional providers of...

There is increasing professional and policy interest in the role of clinical guidelines for promoting effective and efficient health care. The NHS Health Technology Assessment Programme identified an urgent need, when such guidelines are produced, to develop a framework and methods for...

The objective of this paper is to describe a framework in which the causes of ill health (measured ultimately by reduced duration and quality of life) can be identified, and the cost-effectiveness of alternative means of reducing this ill health can be ranked. In the first part of this paper, an...

The number of children resident in large mental handicap hospitals has fallen substantially in recent years but those that remain tend to be amongst the most profoundly handicapped. If the benefits of community care are to be extended to this group of children then new residential facilities...